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Diagnosis and Treatment of Breast Cancer

Breast cancer is characterized by malignant tumor growth in breast gland tissue. Today, more women are living with breast cancer than ever before. Over two million women are breast cancer survivors. With early detection and prompt treatment, the prospects for women with breast cancer can be positive.

No one knows why some women have breast cancer and others do not. Although the disease can affect younger women, 75% of all breast cancers occur in women 50 years of age or older. Some of the risk factors taken include familial or genetic, exposure to estrogen, demographic factors (age, race, ethnicity, and socioeconomic status), nutrition and lifestyle, and smoking.

Symptoms of breast cancer are not as noticeable when they first develop but as they develop, they can lead to changes in women. The most common symptoms are abnormal bumps or swelling in the breast, but bumps can also appear on the breast or under the arm. Other symptoms may include unexplained breast pain, abnormal nipple discharge, changes in breast texture, or changes in skin on or around the breast.

Breast Cancer Examination

For the screen or not the screen - that's a dilemma. The problem is not just medicine but also economic problems. Cancer diagnosis, whether early or recurrent, is the biggest period of acute stress for cancer patients. This crisis is defined by sadness (depression), fear (anxiety), confusion, and occasional anger.

The goal of women's screening for breast cancer is to detect cancer at an early stage when surgery and medical treatment can be most effective in reducing mortality. Examination is only useful when an early diagnosis results in a reduction in mortality and morbidity and when the risk of screening test is low. There are three methods for breast cancer screening now in practice: X-ray mammography, clinical breast examination and breast self-examination.

Of the three methods of screening, the most reliable is mammography. However, in women with very dense breast tissue, both ultrasound and mammogram may miss the tumor, which, however, can be detected by Magnetic Resonance Imager (MRI). MRI is also more accurate for detecting cancers in women carrying the BRCA1 and BRCA2 breast cancer genes. However, the primary diagnosis - and many believe the only definitive one - is a biopsy - a small surgical procedure in which a lump or part of a lump is removed and examined under a microscope for cancer cells. The doctor may perform aspiration needle, needle or core biopsy, or surgical biopsy.

Mammography

Mammograms are special breast x-rays that can often detect cancer that is too small for women or doctors to diagnose. The examination aims to detect early-stage breast cancer when healing is more likely. The amount of radiation required to produce a clear mammogram (picture) varies with breast size and density. To avoid unnecessary exposure, it is essential to use the lowest dose of radiation required.

Mammograms cannot distinguish between malignant or malignant tumors and are not 100% accurate. However, mammography detects more than 90% of all breast cancers although negative mammography does not necessarily indicate its absence. Mammography and clinical examination are complementary and if there is a strong suspicion of the lesion to be felt, the only way to make a positive diagnosis is to have a biopsy.

The results of several large studies show convincingly that breast cancer screening by mammography reduces mortality by about 30% in women over 50 years of age. The American Cancer Society states that women 40 to 49 must receive a mammogram every one to two years. An annual mammography examination is recommended for women 50 and older.

However, the risk of any filtering intervention needs to be evaluated just as benefits. The risks associated with mammography screening for breast cancer include, radiation exposure, false positives, and more diagnoses. The risk of breast cancer caused by radiation from mammographic examination is estimated to be minimal. Excess risk for radiation-induced breast cancer increases with younger women on exposure and increased cumulative radiation dose. However, the benefits of mammography are far greater than the risks of breast cancer due to radiation.

Clinical Breast Examination (CBE)

During a clinical breast examination, doctors examine the breast and arm for a lump or other change that may be a sign of breast cancer. CBE involves bilateral examination and breast palpation and axillary and supraclavicular areas. The examination should be performed in both vertical and bending positions. One of the best predictors of exam accuracy is the amount of time spent by the examiner.

The efficacy of CBE alone in screening for breast cancer is uncertain. The results of several large studies have confirmed the efficacy of CBE when combined with mammography as a screening for breast cancer in women older than 50 years. The American Cancer Society advises that women should have CBE every three years from 20 to 39 years old. Annual CBE should be done for women over 40.

Breast Self Check (BSE)

A systematic examination of a woman in which she used her finger to detect changes in the shape of the breast and fluid removal from the nipple to detect any abnormalities. It is performed ideally every month. Estimates vary, but 80 to 95% are initially seen as bumps in patients. Intuitively, following regular breast examinations as a complementary screening modality with mammography can help to detect some types of cancer early, when prognosis is better.

About four out of every five bumps of the breast are detected as harmless (or harmless) cysts or lesions. However, if a lump is found, it is important to determine as soon as possible whether it is cancerous or not. There are now several epidemiological studies showing that survival is higher in women who undergo breast examinations and that the cancer detected by breast self-examination tends to be smaller.

Treatment

Once breast cancer has been found, it is staged. Through staging, the doctor can determine if the cancer has spread and, if so, what part of the body. More tests can be done to help determine the level. Knowing the level of illness helps plan your doctor's treatment.

The choice of treatment for breast cancer depends on the age and general health, as well as the type, stage, and location of the tumor, and if the cancer remains in the breast or has spread to other parts of the body. There are several treatments, but the most frequently selected women - alone or in combination - are surgery, radiation therapy, chemotherapy, and hormone therapy.

Standard cancer treatments are usually designed for cancer surgery; stop cancer cells from getting the hormones they need to survive and grow through hormone therapy; use high energy beams to kill cancer cells and shrink tumors through radiation therapy and use anti-cancer drugs to kill cancer cells through chemotherapy.

However, the current view holds that cancer is a systemic disease that involves a complex spectrum of host-tumor relationships, with cancer cells spreading through the bloodstream, and therefore variations in local or regional therapies may not affect patient survival. Instead, cancer must be systematically attacked, through the use of radiation therapy, chemotherapy, hormone therapy and immunotherapy.

For women with early stage breast cancer, one of the available treatments is lumpectomy combined with radiation therapy. Lumpectomy is a surgery that maintains a woman's breast. In a lumpectomy, the surgeon simply removes the tumor and a small amount of surrounding tissue. The survival rate for a woman with radiation therapy is the same as for women who choose a radical mastectomy, which completely removes the breast.

If breast cancer has spread throughout the country - only to other areas of breast care - it may involve a combination of chemotherapy and surgery. The doctor first reduced the tumor to chemotherapy and then removed it through surgery. Reducing the tumor before surgery allows a woman to avoid mastectomy and breast care.

If cancer spreads to other parts of the body, such as the lungs or bones, chemotherapy and / or hormone therapy can be used to destroy cancer cells and control the disease. Radiation therapy is also useful for controlling tumors in other parts of the body.

With 30% recurrence of breast cancer, the National Cancer Institute urges all women with breast cancer to undergo chemotherapy or hormone therapy after surgery, although there is no evidence that the cancer has spread. Such systemic displacement therapy, as it is called, can prevent or delay about one-third of relapse.

Breast Cancer Prevention

Breast cancer cannot be completely prevented, but the risk of advanced disease can be reduced with early detection.

Some medicines are now available to treat or prevent breast cancer. Chemopreventive agents such as Tamoxifen and Raloxifene act to prevent the development of breast cancer by interfering with the initiation and promotion of tumors. The antiestrogenic effects of these agents also appear to affect the growth of malignant cells. Chemoprevention is the most promising intervention to achieve primary prevention at this time.

Tamoxifen

Tamoxifen is a nonsteroid anti estrogen with partial estrogen agonist effect. It is approved by the FDA, and is currently used for estrogenemeptive cancer patients as well as for high-risk individuals who are still undergoing estrogen and produce significant estrogen.

Because through the mouth, it can increase the risk of endometrial cancer and can also exacerbate vaginal dryness and hot flashes. Tamoxifen may be less effective as a preventive agent in women with strong breast cancer.

Raloxifene

Raloxifene hydrochloride is a selective estrogen receptor modulator (SERM) that inhibits estrogen action in breast and endometrial tissues. The incidence of invasive breast cancer-positive estrogen receptors was reduced by 76% in women treated with either dose of raloxifene at 40 months follow-up. Side effects of raloxifene include increased risk of thromboembolic disease, but not increased risk of endometrial cancer.

In addition, there have been recent studies linking low incidence of breast cancer to various environmental factors, especially diet. One food that is considered to be cancer prevention is soy (found in foods such as tofu, soy sauce, soy milk and vegetarian substitutes), but there is no clear evidence for that. Consuming more fruits and vegetables, eating less red meat (possibly replacing soy protein) and avoiding cholesterol (missing olive oil) can also help in preventing breast cancer.

One chemical (indole-3-carbinol or I-3-C) found in broccoli, cabbage and other cross-fruits available as a dietary supplement can help prevent estrogen-related breast cancer. Another possible precaution is to use regular doses of anti-inflammatory drugs such as ibuprofen and aspirin twice or twice a week.

Finally, a recent study showed that training helps extend the life of survivors. The exact mechanism is unknown, but it is suspected that physical activity decreases hormone levels, decreases insulin resistance and reduces weight gain, all factors in breast cancer.



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